UVic palliative care expert weighs in on end-of-life ruminations

Those who care for people dying in towns across the province are now able to pick up the phone and call for support around the clock.

On April 10, the Ministry of Health revealed plans to expand the After-Hours Palliative Nursing Service.

By calling HealthLinkBC, those eligible to receive palliative nursing services are connected to a registered nurse. If needed, they can also talk with a palliative response nurse from the Fraser Health Authority, which has provided a call-in service since 2005.

Though families receiving palliative care in Greater Victoria will not see any change in services – Victoria Hospice Society already provides those supports – Dr. Kelli Stajduhar, an expert in end-of-life care and researcher at the University of Victoria’s Centre on Aging, is applauding the decision. Much of Stajduhar’s work exposes her to life’s most common last regrets – a topic that went viral after Bronnie Ware, an Australian palliative care nurse, blogged about her experiences this winter.

Stajduhar weighs in on Ware’s post (summarized below), featured in the Guardian newspaper and shared widely on social media websites.

Top five deathbed regrets as recorded by Bronnie Ware, an Australian palliative care nurse

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.

2. I wish I didn’t work so hard.

3. I wish I’d had the courage to express my feelings.

4. I wish I had stayed in touch with my friends.

5. I wish that I had let myself be happier.

“I wish I would have done what I wanted to do; I wish I wouldn’t have spent all that time in the office and spent more time with my family and played with my kids more and lived my life the way that I wanted to live my life,” Stajduhar said. “These are very common things that people talk about.”

One theme from Stajduhar’s experience not covered by Ware, however, was the regret for having let anger get in the way of maintaining quality family relationships.

Letting go of anger is a lesson often learned not by those on their deathbeds, but also by their caregivers, as the disconnected often return to the family and offer support – despite the quality of the relationship in the past.

Stajduhar recalls meeting a woman who was supporting her husband through what appeared to be the final days of a solid, loving relationship. It wasn’t until speaking with the woman later, once her husband had died, that Stajduhar learned the couple’s marriage had been one fraught with abuse and dishonesty.

“Not all people who are dying are wonderful and nice people. … We often focus on providing the best support for the people who are dying, but we forget their families are providing care to them and they’re not all that nice to their families.”

A little appreciation from the person dying can go a long way, she added.

Stajduhar’s research into caregiving for the dying is rooted in the knowledge that three quarters of people who die in B.C. didn’t share the fact they were dying.

Through a partnership with the Dandelion Society, the Victoria native Friendship Centre, Cool Aid and AIDS Vancouver Island, Stajduhar has recently been able to expand her palliative care work to include the street community.